ICE vs. HEAT – Part 2

Last week, I weighed in on the benefits of ice to treat an injury. In this blog entry, I’m continuing the Ice vs. Heat debate telling you what I tell my patients about the use of Heat!

In my practice I use heat on my patients prior to treating them. But it doesn’t stop there. A day doesn’t go by where I don’t recommend heat to help manage someone’s pain or condition. 90 percent of the conditions I see in my office would be classified as a repetitive strain injury or chronic (with the other 10 percent being acute). Heat is the key when treating repetitive strain or chronic injuries! Heat will increase blood flow, relax muscles, decrease pain and promote healing.

Dr. G’s Tips on when/how to use heat:

use for chronic injuries, if you have tight muscles

use before activity to warm up muscles, not after activity

use at night before bed if you often wake up with stiffness

heat should be applied for 15-20 minutes but can be used for longer (if you use an electrical heating pad, be sure not to fall asleep on it as they can cause burning)

Apply the heat to the area that is the problem…going in a hot tub/sauna or generally applying the heat to a larger area will not have the same affect (as mentioned earlier the goal of using heat is to increase blood flow to the affected area, this can not be achieved if heat is applied to a larger more general area)

recommended to use moist heat rather than dry heat (e.g. Hot water bottle, gel packs, etc)

ICE vs. HEAT Part 1

Could there be anymore of a misunderstanding of when to use ice and when to use heat? Knowing which one to use could make the difference in how you feel and how you ultimately perform! Part 1 - Ice is your friend!
Ice and heat can play critical roles in both the management and treatment of many muscular issues. If used properly, I like to say “Ice is like your friend that tells you what you need to hear not what you want to hear”. In other words, it may not feel good but it’s what you need!! The reason we use ice is not because it feels good, but rather because it is a proven tool against acute, painful and inflammatory conditions.
Simply stated, ice will decrease swelling/inflammation, decrease blood flow, reduce muscle spasms and alleviate bruising and pain.
Whether you are a professional athlete, a weekend warrior, or someone who just wants relief, here are some extremely useful tips:

Dr. G’s Tips on when/how to use ice:

• In my books, anything frozen counts as ice, so if do not have access to ice cubes or and ice pack- grab whatever you can find in your freezer…it will do the trick
• Ice should always be used on acute pain/injuries or a re-aggravation/re-occurrence of an old injury/condition (for clarity “acute” is something new or of sudden onset, is usually a sharper more uncomfortable pain)
• Ice should be applied after activity never before activity
• Apply the ice to the area that is the problem. Going in a cold tub or generally applying the ice to a larger area will not have the same affect (as mentioned earlier the goal of using ice is to decrease swelling and blood flow to the affected area, this can not be achieved if ice is applied to a larger more general area)
• When applying ice to an acute injury, try and get the ice on as quickly as possible after the occurrence and it should be used for the first 24 to 72 hours
• If you have a chronic condition that is aggravated by activity, apply ice as a management tool to decrease the likelihood of a flare up or aggravation
• General rule- apply the ice for 10 minutes on, 20 minutes off (allow enough time for your skin temperature to go back to normal), and then repeat